Wage gap could explain why women are more likely to be anxious and depressed than men

January 5, 2016–The odds of major depressive disorder and generalized anxiety disorder were markedly greater among women who earned less than their male counterparts, with whom they were matched on education and years of experience, according to new research conducted at Columbia University's Mailman School of Public Health. Results of the study are online in the journal Social Science & Medicine.

The odds that an American woman was diagnosed with depression in the past year are nearly twice that of men. However, this disparity looks very different when accounting for the wage gap: Among women whose income was lower than their male counterparts, the odds of major depression were nearly 2.5 times higher than men; but among women whose income equaled or exceeded their male counterparts, their odds of depression were no different than men.

Results were similar for generalized anxiety disorder. Overall, women's odds of past-year axiety were more than 2.5 times higher than men's. Where women's incomes were lower than their male counterparts, their odds of anxiety disorder were more than four times higher. For women whose income equaled or exceeded their male counterparts, their odds of anxiety disorder were greatly decreased.

The findings are based on data from a 2001-2002 U.S. population-representative sample of 22,581 working adults ages 30-65. Researchers tested the impact of structural wage disparities on depression and anxiety outcomes, according to criteria in the Diagnostic and Statistical Manual, version IV (DSM-IV).

"Our results show that some of the gender disparities in depression and anxiety may be due to the effects of structural gender inequality in the workforce and beyond," said Jonathan Platt, a PhD student in the Department of Epidemiology, who was the first author of the paper. "The social processes that sort women into certain jobs, compensate them less than equivalent male counterparts, and create gender disparities in domestic labor have material and psychosocial consequences."

While the U.S. has passed legislation to address some of the most overt forms of gender discrimination faced by working women, less conspicuous forms of structural discrimination persist. As examples, the researchers refer to the norms, expectations, and opportunities surrounding the types of jobs women occupy and the way those jobs are valued and compensated relative to men.

"If women internalize these negative experiences as reflective of inferior merit, rather than the result of discrimination, they may be at increased risk for depression and anxiety disorders," says Platt.

"Our findings suggest that policies must go beyond prohibiting overt gender discrimination like sexual harassment," said Katherine Keyes, PhD, assistant professor of Epidemiology and senior author. "Further, while it is commonly believed that gender differences in depression and anxiety are biologically rooted, these results suggest that such differences are much more socially constructed that previously thought, indicating that gender disparities in psychiatric disorders are malleable and arise from unfair treatment ."

According to Keyes, policies such as paid parental leave, affordable childcare, and flexible work schedules may ameliorate some of this burden, although more research into understanding the ways in which discrimination plays a role in mental health outcomes is needed.

"Structural forms of discrimination may explain a substantial proportion of gender disparities in mood and anxiety disorders in the U.S. adult population," said Keyes. "Greater attention to the fundamental mechanisms that perpetuate wage disparities is needed, not only because it is unjust, but so that we may understand and be able to intervene to reduce subsequent health risks and disparities."

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The work was supported in part by the National Institutes of Mental Health Psychiatric Epidemiology training grant (5-T32-MH-13043-43).

Co-authors are Seth J. Prins, MPH, and Lisa Bates, ScD, in the Department of Epidemiology. The authors report no conflict of interests.

About Columbia University's Mailman School of Public Health

Founded in 1922, Columbia University's Mailman School of Public Health pursues an agenda of research, education, and service to address the critical and complex public health issues affecting New Yorkers, the nation and the world. The Mailman School is the third largest recipient of NIH grants among schools of public health. Its over 450 multi-disciplinary faculty members work in more than 100 countries around the world, addressing such issues as preventing infectious and chronic diseases, environmental health, maternal and child health, health policy, climate change & health, and public health preparedness. It is a leader in public health education with over 1,300 graduate students from more than 40 nations pursuing a variety of master's and doctoral degree programs. The Mailman School is also home to numerous world-renowned research centers including ICAP (formerly the International Center for AIDS Care and Treatment Programs) and the Center for Infection and Immunity. For more information, please visit http://www.mailman.columbia.edu